RBD Longitudinal as Prognostic for PD - Full Text View

Sponsor:	The University of Texas Health Science Center, Houston
Information provided by:	The University of Texas Health Science Center, Houston
ClinicalTrials.gov Identifier:	NCT00817726

Purpose

Purpose - to validate a combination of biological and clinical markers in the rapid-eye-movement (REM) sleep behavior disorder (RBD) population as indicative of the pre-symptomatic stage of Parkinson's disease (PD).
Procedures - All subjects (RBD diagnosis, PD diagnosis and controls) will have 1) a medical and neuro history and physical including videotape of movements, 2) neuropsychological testing, 3) a sleep study, 4) olfactory testing, 5) blood draw & LP for serum and CSF testing, 6) functional MRI, & 7) eye tracking test OR CANTAB cognitive testing. All of these procedures are often performed clinically in the diagnosis of PD. Any testing performed prior to enrollment as part of the clinical evaluation may be used in place of repeating the procedure for the study. Subjects will be followed for 5 years. It is hypothesized that a 5 year follow up may capture a significant number of pre-Parkinson's subjects who will be diagnosed. Changes over time in the PD population may also capture significant information.

Condition
Rapid Eye Movement Sleep Behavior Disorder Parkinson's Disease Parkinsonian Disorders

Study Type:	Observational
Study Design:	Observational Model: Case-Crossover Time Perspective: Prospective
Official Title:	A Natural History Analysis of Rapid Eye Movement Sleep Behavior Disorder as Prognostic for Parkinson's Disease

Resource links provided by NLM:

Genetics Home Reference related topics: familial paroxysmal nonkinesigenic dyskinesia Parkinson disease Perry syndrome

MedlinePlus related topics: Parkinson's Disease

U.S. FDA Resources

Further study details as provided by The University of Texas Health Science Center, Houston:

Primary Outcome Measures:

Identify the key cognitive and non-motor characteristics for early PD diagnosis [ Time Frame: 5 years ] [ Designated as safety issue: No ]
evalate periodically performed set of clinical and imaging parameters suspected to be linked to PD to see if, as a group, these parameters could identify those at risk for motor symptoms of PD before these symptoms develop.

Secondary Outcome Measures:

Further characterize the sleep behavior patterns, olfactory function, and neurologic assessments of subjects longitudinally, over 5 years, within each group of patients. [ Time Frame: 5 years ] [ Designated as safety issue: No ]
functional MRI of the brain and eye tracking testing, identification of distinct features in PD [ Time Frame: beginning of study ] [ Designated as safety issue: No ]
identify key fluid-based PD-associated molecular markers that identify disease state or progression [ Time Frame: 5 years ] [ Designated as safety issue: No ]
parameters within blood and cerebrospinal fluid may be present & measurable well before motor symptoms of PD are seen.

Biospecimen Retention: Samples With DNA

CSF, blood (serum)

Estimated Enrollment:	120
Study Start Date:	January 2009

Groups/Cohorts
1 polysomnographically diagnosed RBD patients. RBD is a sleep disorder diagnosed by a sleep lab in which the individual has muscle movements during the phase of deep sleep during which the muscles should be relaxed.
2 age and gender matched controls with polysomnographically confirmed non-RBD diagnosis. These controls must not have any neurological degenerative diagnosis.
3 early iPD diagnosed patients. Early is defined as within 5 years of diagnosis, and with no surgical interventions for treatment (such as DBS).
4 Atypical Parkinsonian Syndromes: MSA, PSP, unspecified parkinsonian diagnoses

Detailed Description:

Atypical Parkinsonian syndromes have been added as a cohort. It is not yet known whether people diagnosed with RBD may go on to have iPD (classic symptoms of PD) or an atypical form.

Eligibility

Ages Eligible for Study:	35 Years to 75 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes
Sampling Method:	Non-Probability Sample

Study Population

Patients with polysomnographically-documented RBD, non-neurodegenerative diagnosis Age and gender matched non-RBD diagnosis, non-neurodegenerative diagnosis idiopathic PD diagnosis

Criteria

Inclusion Criteria:

35-75 year old men & women
(1) Diagnosis of idiopathic RBD (see AASM criteria), 2) Normal control or control with a non-neurodegenerative disorder, age and gender-matched to (1), (3) idiopathic PD, or (4) atypical parkinsonian syndrome.
Gives written informed consent
Pregnant women are not excluded, but will be identified by HCG.

Exclusion Criteria:

a A diagnosis of any non-Parkinsonian Neurodegenerative Disease.

b. Any unstable or uncontrolled medical or psychiatric condition.

c. Parasomnia or RBD not idiopathic, eg., secondary to metabolic derangement or medicine effect.

d. Renal (creatinine over 1.6) or hepatic insufficiency (LFT significantly out of range), or a history of significant uncontrolled cardiac disease.

e. IF there is a history or evidence of coagulopathy, on medications such as Plavix, Aggrenox, heparin, coumadin, or large doses of aspirin, must be able to remain off these medications for at least 3 days, and have stable blood coagulation values prior to any research or clinically performed lumbar puncture.

f. Significant dementia (MMSE<25 of 30 or MOCA<25/30) that would interfere with study procedures or informed consent.

g. Active infections including skin, respiratory or GI infections, and HIV+ (if undergoing an LP).

h. Any reason which, in the opinion of the PI, would increase the risk or decrease the value of any study procedure.

i. fMRI will not be performed for anyone for whom the screening questionnaire indicates is ineligible for MRI imaging.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00817726

Contacts

Contact: Vicki J Ephron, RN	713-500-7073	Vicki.J.Ephron@uth.tmc.edu
Contact: Mya C Schiess, MD	713-500-7121	Mya.C.Schiess@uth.tmc.edu

Locations

United States, Texas
University of texas Health Science Center at Houston	Recruiting
Houston, Texas, United States, 77030
Contact: Vicki J Ephron, RN 713-500-7073 vicki.j.ephron@uth.tmc.edu
Contact: Mya C Schiess, MD 713-500-7121 Mya.C.Schiess@uth.tmc.edu
Sub-Investigator: Erin F Stimming, MD

Sponsors and Collaborators

The University of Texas Health Science Center, Houston

Investigators

Principal Investigator:

Mya C Schiess, MD

The University fo texas Health Science Center at Houston

More Information

No publications provided

Responsible Party:	Mya Schiess, MD, The University of Texas Health Science Center, Houston
ClinicalTrials.gov Identifier:	NCT00817726 History of Changes
Other Study ID Numbers:	SchiessRBD6YR2008
Study First Received:	January 5, 2009
Last Updated:	January 31, 2011
Health Authority:	United States: Institutional Review Board

Keywords provided by The University of Texas Health Science Center, Houston:

Rapid Eye Movement Sleep Behavior Disorder
Parkinson's Disease
Parkinsonian Syndromes
Atypical Parkinson's
RBD

PD
fMRI
PSP
MSA

Additional relevant MeSH terms:

Mental Disorders
Parkinson Disease
Parkinsonian Disorders
REM Sleep Behavior Disorder
Basal Ganglia Diseases
Brain Diseases
Central Nervous System Diseases

Nervous System Diseases
Movement Disorders
Neurodegenerative Diseases
REM Sleep Parasomnias
Parasomnias
Sleep Disorders

ClinicalTrials.gov processed this record on February 09, 2012